Lynne
Friedli's WHO
Report on Mental
Health, Resilience and Inequalities is a useful
and very informative drawing-together of the evidence for the
socio-psychological damage
done by material inequality.

Richard Wilkinson and Kate Pickett's
book The
Spirit Level continues to make an impact. It was featured in The
Guardian in March '09 (see also Paul Moloney's review here).The
Equality Trust, founded on the book, has a website that
is well worth a visit.

The
Marmot
review of health inequalities in England was published
on 11.2.10. Yet again the relation between relative poverty
and ill health is spelt out unequivocally. The key messages
of the review were:-

1
Reducing health inequalities is a matter
of fairness and social justice. In England,
the many people who are currently dying
prematurely each year as a result of health
inequalities would otherwise have enjoyed,
in total, between 1.3 and 2.5 million extra
years of life.

2 There is a social gradient in health – the
lower a person’s social position, the worse
his or her health. Action should focus on
reducing the gradient in health.

3 Health inequalities result from social
inequalities. Action on health inequalities
requires action across all the social determinants
of health.

4 Focusing solely on the most disadvantaged
will not reduce health inequalities sufficiently. To reduce the steepness of
the social
gradient in health, actions must be universal,
but with a scale and intensity that is
proportionate to the level of disadvantage. We call this proportionate universalism.

5 Action taken to reduce health inequalities
will benefit society in many ways. It
will have economic benefits in reducing
losses from illness associated with health
inequalities. These currently account for
productivity losses, reduced tax revenue,
higher welfare payments and increased
treatment costs.

6
Economic growth is not the most important
measure of our country’s success. The
fair distribution of health, well-being and
sustainability are important social goals.
Tackling social inequalities in health and
tackling climate change must go together.

— Give every child the best start in life
— Enable all children young people and
adults to maximise their capabilities
and have control over their lives
— Create fair employment and good work
for all
— Ensure healthy standard of living for all
— Create and develop healthy and sustainable
places and communities
— Strengthen the role and impact of ill
health prevention

8 Delivering these policy objectives will
require action by central and local government,
the NHS, the third and private
sectors and community groups. National
policies will not work without effective local
delivery systems focused on health equity
in all policies.

9 Effective local delivery requires effective
participatory decision-making at local
level. This can only happen by empowering
individuals and local communities.